窦性心率震荡预测急性心肌梗死患者预后的临床研究
李厚荣,何娟,杜国伟,殷波,金海燕,向娟,李倩
(三峡中心医院心电科,重庆 404100)
Clinical research of heart rate turbulence on predictive value in patients with acute myocardial infarction
摘要 目的 探讨心率震荡(HRT)在急性心肌梗死(AMI)患者中对近期预后的预测价值及心率变异(HRV)的相关性。 方法 选择符合条件的200例AMI后窦性心律的患者,平均随访20.6个月。入选者记录24 h 动态心电图,分别检测HRT的震荡起始(TO)、震荡斜率(TS)及HRV的时域指标、24 h R-R间期标准差(SDNN)并 进行分析,终点事件为心源性死亡。 结果 AMI后死亡组(36例)TS明显减弱(P <0.05),TO明显升高,与幸存组(164例)比较差异均有统计学意义( P <0.05)。TS与SDNN之间存在相关性(r =0.447, P =0.009)。 结论 HRT 参数TO和TS值可成为评估AMI患者自主神经功能状态,预测恶性心血管事件及心性猝死的新指标。
关键词 :
心率震荡 ,
急性心肌梗死 ,
动态心电图 ,
室性期前收缩 ,
心性猝死
Abstract :Objective To explore the HRT and short term prognostic value of heart rate turbulence on acute myocardial infarction and the relationship of HRT and heart rate variability. Methods Chose 200 patients with sinus rhythm after AMI to monitor their 24 h dynamic electrocardiography,TO,TS, HRV time domain indexes and 24 h R-R interval standard difference during the follow-up survey period of 20.6 months. The end event is cardiac death. Results Compared with the survival group(164 patients),the TS of the death group after AMI(36 patients)weakened obviously(P <0.05)and the TO increased. There is a significant correlation between TS and SDNN(r =0.447,P =0.009). Conclusions The values of TO and TS(factors of HRT)may be a new predictor to evaluate the autonomic nerve activity and predict the adverse cardiovascular events and sudden cardiac death of patients after AMI.
Key words :
heart rate turbulence
acute myocardial infarction
dynamic electrocardiography
ventricular extrasystole
sudden cardiac death
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